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Outcomes Following Cytoreduction and HIPEC for Pseudomyxoma Peritonei: 10-Year Experience

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Pseudomyxoma peritonei (PMP) is a rare clinical presentation, with considerable morbidity and mortality if left untreated. In recent decades, there is growing acceptance for the use of cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC). The aim of this study was to report on our 10-year single-center experience on outcomes following CRS and HIPEC for PMP of appendiceal origin.

Methods

A retrospective analysis of a prospectively maintained database of all patients undergoing CRS and HIPEC for PMP of appendiceal origin over a 10-year period at a statewide referral center was conducted.

Results

One hundred and seventy-five cytoreductive procedures were undertaken in 140 patients. The mean patient age was 57.4 years, with a female preponderance (56%). The median PCI was 16, with 73.1% of cases having a complete cytoreduction. Grade III/IV complications occurred in 36 (20.6%) cases, with no mortalities. The median overall and disease-free survival was 100 months and 40 months, respectively, with a 71% 5-year survival. High-grade histology was the main factor identified as an independent predictor of worse overall survival.

Conclusion

CRS and HIPEC are safe with acceptable rates of morbidity. It can provide very favorable survival in patients with PMP. High-grade histology is a key prognostic factor associated with a worse overall survival.

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Author information

Author notes

  1. Vignesh Narasimhan and Kasmira Wilson contributed equally to this work.

Authors and Affiliations

  1. Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia

    Vignesh Narasimhan, Kasmira Wilson, Maneka Britto, Satish Warrier, A. Craig Lynch, Robert Ramsay & Alexander Heriot

  2. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia

    Vignesh Narasimhan, Kasmira Wilson, Michael Michael, Tim Akhurst, Catherine Mitchell, Robert Ramsay & Alexander Heriot

  3. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia

    Michael Michael & Jeanne Tie

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  1. Vignesh Narasimhan
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  2. Kasmira Wilson
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Contributions

VN, MM, RR, and AH produced the study concept and design. VN, KW, and MB performed the scientific literature search. VN, KW, and MB did all the data collection. VN performed all the statistical analysis. All authors were involved in refining the study design and data interpretation. VN, KW, SW, CL, MM, JT, CM, TA, RR, and AH wrote the initial draft, with all authors involved in the editing process and final version of the manuscript. All authors have reviewed and approved the final manuscript. All authors agree to be accountable for all aspects of the work.

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Correspondence to Vignesh Narasimhan.

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Narasimhan, V., Wilson, K., Britto, M. et al. Outcomes Following Cytoreduction and HIPEC for Pseudomyxoma Peritonei: 10-Year Experience. J Gastrointest Surg 24, 899–906 (2020). https://doi.org/10.1007/s11605-019-04239-4

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  • DOI: https://doi.org/10.1007/s11605-019-04239-4

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